The National Diabetes Education Program (NDEP) is a joint initiative sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health, and the Division of Diabetes Translation of the Centers for Disease Control and Prevention (CDC). The development of NDEP involved broad input from over 100 organizations concerned with diabetes and health. Its mission is to:
- increase public awareness of the seriousness of diabetes, its risk factors, and potential strategies for preventing diabetes and its complications;
- improve understanding of diabetes and its control by promoting self-management behaviors among people with diabetes;
- improve health care providers' understanding of diabetes and its control;
- encourage an integrated approach to care; and
- advocate for health care policies that improve quality and access to diabetes care.
A recent editorial in Journal of the American Medical Association (2000;284;363-365) reported that the NDEP is increasing its efforts, particularly with regard to early detection and diagnosis and intensive treatment for those already diagnosed, stressing the importance of utilizing the fasting blood glucose as a diagnostic tool and hemoglobin A1c for ongoing monitoring.
While it is estimated that 16 million people in the US have diabetes, only about one-half of them have been diagnosed. It is not unusual for diabetes to go unrecognized for many years, allowing ample time for its sequelae to develop. There are statistics showing that, in newly diagnosed with type 2 diabetes, 15-20% already have eye disease, and 5-10% have early signs of kidney disease. In addition, it is well understood that many patients with type 2 diabetes also have obesity, blood fat disorders, and high blood pressure, all of which are associated with the development of heart disease. Adequate diagnosis and treatment can prevent or limit the progression of many of these complications.
The HbA1c test has become "the gold standard" by which blood glucose control is monitored. However, studies reveal that it is likely that this test is only performed on about one-half of adults, only about 16% of patients have it performed according to standards, and that there are many who have never even heard about it. This may be due to the fact that the question as to whether or not complication can be prevented was not known until studies were published less than 10 years ago. Additionally, threatened reductions in Medicare threaten lack of funding for such tests and education of people with diabetes.
The editorial stressed the ongoing and imminent necessity of increasing awareness of diabetes, sometimes known as "The Silent Killer," to the general public, healthcare providers, the insurance companies, and legislators. The NDEP emphasizes that increase diagnosis and testing, will significantly decrease the costs currently related to diabetes. With the population of people with diabetes increasing, at an alarming rate, annually, we must take these steps now.
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Published 24 September, 2000
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